@mao22 I'll post if I find out anything on this and let me know if you do! Evenity is so new, there is little data. Even McCormick doesn't cover this in "Great Bones." I'll be asking him next week, and my doc. I have an additional concern because due to kidney disease, Evenity may hang around even longer for me.
windyshores, this great! I look forward to hearing what Dr. McCormick has to say about this. You and I are on the same Evenity path - at least at the moment.
My endocrinologist (not making much eye contact at last visit) said Fosamax when I finished Evenity. I know I can’t take that, so I said “Reclast.” He said,
“Okay.” So, the patient has to decide their treatment.
@mao22 I'll post if I find out anything on this and let me know if you do! Evenity is so new, there is little data. Even McCormick doesn't cover this in "Great Bones." I'll be asking him next week, and my doc. I have an additional concern because due to kidney disease, Evenity may hang around even longer for me.
My thoughts exactly!!
Where are we able to get real answers to those questions? I need to figure that out in the next 2 months as my 12th Evenity shots are on March 7th.
I reread his book and watched Leder's video and all drugs have a rebound to some extent, including Evenity, but none of them have the intense drop off in bone density and especially the increased fracture risk that can happen in the first year after stopping Prolia (It does make a difference how long we have been on Prolia to some extent.).
So far it is known that the bone gains with Evenity are lost if not followed up with another med (anti-resorptive) to keep those gains from disappearing. So they have I presume measured this bone loss. This happens for Forteo and Tymlos also. Prolia can cause something beyond that. You don't just lose what you gained you may become extremely fracture prone. Some have multiple fractures in a short period of time. Very scary.
This has so far not been reported with Forteo, Tymlos, or Evenity. It's best not to mix up bone loss after stopping an anabolic medication with the possible extreme fracture rate that sometimes happens with Prolia. Maybe the phrase rebound effect should be reserved for Prolia. Though in my mind "rebound effect" is not a strong enough warning for what could happen after stopping Prolia.
i agree with you on prolia i had only 1 shot and no more and after stopping it i had 3 compression fracture so prolia as far as i am concerned is no good
Can anyone explain the advantages of going off of Prolia and going onto Reclast instead? I have had 3 Prolia injections and have been happy on it. I have just started with a new physician group which recommends switching from Prolia to Reclast, but I am afraid of the side effects with Reclast.
Can anyone explain the advantages of going off of Prolia and going onto Reclast instead? I have had 3 Prolia injections and have been happy on it. I have just started with a new physician group which recommends switching from Prolia to Reclast, but I am afraid of the side effects with Reclast.
Some docs don't like to use Prolia because it is so hard to get off. The rebound causes a sudden drop in bone density and increase in fracture risk. This can be mitigated by going on Reclast.
I hope you can ask your doctor their reasoning. It might be because the longer you are on Prolia, the harder it is to get off. There is no such issue with Reclast. Then again I know women who are on Prolia for years. If you are older it might be worth considering (if getting off won't be an issue).
Some docs don't like to use Prolia because it is so hard to get off. The rebound causes a sudden drop in bone density and increase in fracture risk. This can be mitigated by going on Reclast.
I hope you can ask your doctor their reasoning. It might be because the longer you are on Prolia, the harder it is to get off. There is no such issue with Reclast. Then again I know women who are on Prolia for years. If you are older it might be worth considering (if getting off won't be an issue).
That's what I think. I'm 81 years old and at this point in my life, I don't see why I should get off of Prolia if it agrees with me to try something unknown. I have been dealing with the PA in the office, but have never spoken to a physician in this practice. Although she seems very knowledgeable, I would like to discuss this with a physician. Thanks.
The doctor I have a lot of respect for understood the concern McCormick expressed about timing of Reclast after Evenity or Prolia, but says studies show there is no need to wait for the CTX to go up, that the standard timing (30 days after Evenity and I believe 6 months after Prolia) works. So I have run into a difference of opinion. I have also run into different opinions on the value of blood markers like CTX and P1NP in terms of getting a full picture of what is going on.
I've been trying to understand how Evenity works so that I can compare it to other OP drugs that have an anti-resorpative effect. Here's what I learned to the best of my understanding:
The rebound and the degree to which it happens depends on the drug's anti-resorpative mechanism. Bisphosphonates, Prolia, and Evenity impact osteoclasts in different ways and at different points in their development.
Bisphosphonates kill osteoclasts. These drugs have a long half life, so your bone turnover gradually returns to normal as the bisphosphonates wear off.
Prolia suppresses the osteoclasts by turning them into osteomorphs rendering them inactive, though they are still there, and continue being created and accumulating while you're on the drug. When you stop the drug, they fire up again . The longer you're on the drug, the more they accumulate. When you stop Prolia, as it wears off, the osteomorphs turn into osteoclasts. You have more of them than you normally would, and the rate of bone loss is accelerated.
Evenity inhibits osteoclast formation. Because the drug is so new, there isn't much information that I could find regarding what happens when the treatment ends. To the best of my understanding, the number of new osteoclasts being formed during treatment is greatly reduced. It stands to reason that there aren't huge numbers of them laying in wait like there are with Prolia. Still, I can't find anything that explains whether or not the formation of them accelerates or just returns to your "normal" rate when the treatment ends, and the drug wears off. Evenity is also anabolic, and bone growth slows down again after use, so this clearly impacts things too.
If anyone else knows where to find information about what happens physiologically in regards to osteoclast formation when you stop taking Evenity, please share.
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windyshores, this great! I look forward to hearing what Dr. McCormick has to say about this. You and I are on the same Evenity path - at least at the moment.
My endocrinologist (not making much eye contact at last visit) said Fosamax when I finished Evenity. I know I can’t take that, so I said “Reclast.” He said,
“Okay.” So, the patient has to decide their treatment.
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1 ReactionPlease keep us posted on McCormicks thoughts.
Please let me know as well. I am done with Evenity in early June
I reread his book and watched Leder's video and all drugs have a rebound to some extent, including Evenity, but none of them have the intense drop off in bone density and especially the increased fracture risk that can happen in the first year after stopping Prolia (It does make a difference how long we have been on Prolia to some extent.).
i agree with you on prolia i had only 1 shot and no more and after stopping it i had 3 compression fracture so prolia as far as i am concerned is no good
Can anyone explain the advantages of going off of Prolia and going onto Reclast instead? I have had 3 Prolia injections and have been happy on it. I have just started with a new physician group which recommends switching from Prolia to Reclast, but I am afraid of the side effects with Reclast.
Some docs don't like to use Prolia because it is so hard to get off. The rebound causes a sudden drop in bone density and increase in fracture risk. This can be mitigated by going on Reclast.
I hope you can ask your doctor their reasoning. It might be because the longer you are on Prolia, the harder it is to get off. There is no such issue with Reclast. Then again I know women who are on Prolia for years. If you are older it might be worth considering (if getting off won't be an issue).
That's what I think. I'm 81 years old and at this point in my life, I don't see why I should get off of Prolia if it agrees with me to try something unknown. I have been dealing with the PA in the office, but have never spoken to a physician in this practice. Although she seems very knowledgeable, I would like to discuss this with a physician. Thanks.
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Hug
1 ReactionThe doctor I have a lot of respect for understood the concern McCormick expressed about timing of Reclast after Evenity or Prolia, but says studies show there is no need to wait for the CTX to go up, that the standard timing (30 days after Evenity and I believe 6 months after Prolia) works. So I have run into a difference of opinion. I have also run into different opinions on the value of blood markers like CTX and P1NP in terms of getting a full picture of what is going on.
-
Like -
Helpful -
Hug
1 ReactionI've been trying to understand how Evenity works so that I can compare it to other OP drugs that have an anti-resorpative effect. Here's what I learned to the best of my understanding:
The rebound and the degree to which it happens depends on the drug's anti-resorpative mechanism. Bisphosphonates, Prolia, and Evenity impact osteoclasts in different ways and at different points in their development.
Bisphosphonates kill osteoclasts. These drugs have a long half life, so your bone turnover gradually returns to normal as the bisphosphonates wear off.
Prolia suppresses the osteoclasts by turning them into osteomorphs rendering them inactive, though they are still there, and continue being created and accumulating while you're on the drug. When you stop the drug, they fire up again . The longer you're on the drug, the more they accumulate. When you stop Prolia, as it wears off, the osteomorphs turn into osteoclasts. You have more of them than you normally would, and the rate of bone loss is accelerated.
Evenity inhibits osteoclast formation. Because the drug is so new, there isn't much information that I could find regarding what happens when the treatment ends. To the best of my understanding, the number of new osteoclasts being formed during treatment is greatly reduced. It stands to reason that there aren't huge numbers of them laying in wait like there are with Prolia. Still, I can't find anything that explains whether or not the formation of them accelerates or just returns to your "normal" rate when the treatment ends, and the drug wears off. Evenity is also anabolic, and bone growth slows down again after use, so this clearly impacts things too.
If anyone else knows where to find information about what happens physiologically in regards to osteoclast formation when you stop taking Evenity, please share.
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Helpful -
Hug
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